27th July 2023

A 93 year old woman is admitted to the geriatric unit with hyponatremia and hypomagnesemia secondary to prolonged PPI use.

A 93 year old woman is admitted to the geriatric unit with hyponatremia and hypomagnesemia secondary to prolonged PPI use. She also has multiple grades 1 and 2 pressure ulcers over her heel and sacrum. You review her on your ward round and notice that the pressure ulcer over her heel has changed. There is new surrounding erythema that is tender and warm to the touch. The nurses inform you that she has spiked a temperature of 38 degrees and is currently tachycardic at 104 bpm. Her blood pressure is normal, and her examination of other systems are unremarkable. Blood tests show a mild elevation in her inflammatory markers. CXR shows no new changes.

What is the most appropriate next step in management?

Select the SINGLE most appropriate option from the list below. Select ONE option only.